Residents Should Not Independently Perform Focused Abdominal Sonography for Trauma After 10 Training Examinations

Objectives. To assess whether 10 focused abdominal sonography for trauma (FAST) examinations could be used as a minimum standard for training, as suggested previously. Methods. This was a retrospective review of patients with abdominal trauma who underwent resident‐performed FAST examinations before surgical or Department of Radiology evaluation. Results. Six hundred ninety‐eight patients were examined by resident‐performed FAST followed by reference standard evaluations. Four hundred twelve patients were evaluated by residents who previously performed 10 FAST examinations; 154 were evaluated by 29 residents performing their 11th through 30th examinations; and 258 were evaluated by 10 residents performing their 31st and subsequent examinations. The results of resident‐performed FAST for intraperitoneal free fluid were as follows: 11 to 20 examinations—sensitivity, 73.9% (95% confidence interval, 51.3%–88.9%); specificity, 98.8% (92.5%–99.9%); true‐positive findings, 17; true‐negative, 81; false‐positive, 1; false‐negative, 6; total patients, 105; 21 to 30 examinations—sensitivity, 100% (73.2%–100%); specificity, 97.1% (83.3%–99.9%); true‐positive, 14; true‐negative, 34; false‐positive, 1; false‐negative, 0; total patients, 49; 31 and more examinations—sensitivity, 94.8% (88.6%–97.9%); specificity, 98.6% (94.5%–99.8%); true‐positive, 110; true‐negative, 140; false‐positive, 2; false‐negative, 6; total patients, 258. Conclusions. The suggestion that 10 examinations could be used as a minimum standard for training in FAST examinations was not validated.     

An investigation into sonography student experiences of simulation teaching and learning in the acquisition of clinical skills

Technological developments are impacting on many aspects of life, including education. One particular area of technology where there is growing interest within higher education institutions (HEIs) offering healthcare training is the use of simulators. The literature shows diverging views on the role of simulated learning in healthcare and further evaluation is needed to explore the quality of learning opportunities that are offered, and their effectiveness in the preparation of students for clinical practice. A qualitative study was undertaken, using interviews to explore the experiences of a group of sonography students after interacting with an ultrasound simulator. Simulation was positively evaluated by students in this study. The findings confirm that simulated learning enables students to be interactive learners rather than being passive recipients of knowledge. Simulated learning provides learning opportunities in a risk free environment, which reduces stress for the student and potential harm to patients. Confidence levels were increased, thereby improving future clinical scanning experiences for both the student and their patients. Suggestions were made for the more effective integration of simulated learning into the curriculum. Continued research into simulation, teaching and learning practices needs to occur if we are to ensure maximum advantage of the simulation experience.     

子宫粘膜下肌瘤的阴道超声诊断分析

目的：评价经阴道超声诊断子宫粘膜下肌瘤的价值.方法：回顾性分析86例患者的经阴道超声检查结果,并与手术病理结果对照.结果：阴道超声诊断准确率85%,8例误诊为子宫内膜息肉,4例误诊为子宫内膜增厚,1例误诊为子宫内膜癌.结论：阴道超声对子宫粘膜下肌瘤有较高的临床诊断价值.     

Three‐Dimensional Sonography in the Evaluation of Primary Hyperparathyroidism

Three‐dimensional sonography is useful in the preoperative evaluation of patients with primary hyperparathyroidism. In this pictorial essay, we review the characteristic spectrum of grayscale and Doppler appearances of parathyroid glands on 2‐dimensional sonography and demonstrate the additional benefits of 3‐dimensional scanning.     

Sonography of the Scrotum

In this pictorial essay, we review and discuss the varying morphologic characteristics of scrotal appendages and calculi. Characteristic sonograms obtained from patients with coexisting hydrocele are presented, and recent literature is included. Hydrocele greatly facilitates the imaging of these intrascrotal structures, as it acts as a “water path”. On the one hand, torsion of a scrotal appendage should always be included in the differential diagnosis of acute scrotum, especially in children. On the other hand, scrotolithiasis may occasionally cause mild discomfort. As a consequence, and given the widespread use of sonography for the evaluation of both acute and chronic conditions of the scrotum, radiologists should be familiar with these entities.     

Sonography of the Achilles Tendon After Complete Rupture Repair

This review aims to provide the radiologist with simple and systematic guidelines for evaluation of the Achilles tendon after complete rupture repair. Currently, there is a plethora of nonsurgical and surgical treatments, but sonographic examination has shown no significant differences between them. A systematic analysis of several parameters (morphologic characteristics, structure, color Doppler vascularization, and mobility) should be undertaken. Morphologically, the repaired tendon is larger, wider, or both. The loss of the fibrillary structure, inhomogeneity, and the surgical material in the context of the tendon are “normal” aspects after a repaired rupture. The presence of fluid collections when affecting greater than 50% of the surface of the tendon and extensive calcifications should be considered pathologic aspects. In the immediate postoperative period, there is the absence of vascularization detectable by color Doppler imaging. During the first 3 months, there is an increase in intratendinous vascularization with hypervascularization. From 3 to 6 months, stabilization and regression of the vascularization occur. Beyond the first 6 months, the hypervascularization is pathologic. The pattern of motion is, generally, reduced considerably more often in surgically treated tendons than in non–surgically treated ones. Elastography generally shows a hard appearance, with only a relatively heterogeneous pattern. In conclusion, a treated tendon will never regain a normal sonographic appearance, and the operator must distinguish between normal posttreatment changes and real pathologic characteristics.     

7532例乳腺超声体检分析

目的 用高频超声对正常女性乳腺健康体检,探讨其在临床及乳腺普查方面的应用价值.方法 对2006年1月-2009年12月间7 532例健康女性乳腺体检声像图进行分析,并对各年龄段的乳腺病变超声结果分布情况进行统计.结果 共检出乳腺病变2 861例(37.98%),正常者4 671例(62.02%).所有受检者中,囊性病变...     

Sonography of the Coracoid Process Region

Sonography is widely known as an accurate imaging tool for assessment of the rotator cuff of the shoulder, the long head of the biceps tendon, and joint disorders, but it is rarely performed to evaluate the coracoid process and the adjacent soft tissues. Nevertheless, sonography can show anatomic details of this region and be used to assess several pathologic conditions. The aims of this pictorial essay are to briefly review the anatomy of the coracoid process region, describe examination technique and normal sonographic appearances, and present the sonographic findings of the main disorders affecting this region.     

Role of Sonography for Evaluation of Gastrointestinal Foreign Bodies

Foreign body ingestion is frequently encountered in children. The locations of the foreign bodies and the period during which they have been present in the thorax and abdomen are important for determining the method and timing of treatment. Although plain radiography and computed tomography are primarily used for assessment of foreign bodies, sonography without radiation is also useful for diagnosis of foreign bodies. This report describes 5 cases of foreign bodies in the digestive tract and the usefulness of sonography for real‐time evaluation of foreign bodies with high spatial resolution. Physicians can use sonography along with radiography and computed tomography in cases involving foreign bodies.